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Objective:Crimean-Congo Hemorrhagic Fever (CCHF) is a disease of the viral hemorrhagic fever group and is endemic in certain regions in Turkey. Here, the demographic, clinical, and laboratory findings of patients diagnosed with CCHF during the Coronavirus disease-2019 (COVID-19) pandemic were examined, and differential diagnosis was stressed.Methods:This study comprised 12 patients over the age of 18 who were admitted to our clinic after the onset of the COVID-19 pandemic on March 11, 2020 and whose CCHF diagnosis was confirmed by reverse transcription-polymerase chain reaction with viral-RNA or enzyme-linked immunosorbent assay with immunoglobulin M antibodies. Epidemiological, clinical, and laboratory findings as well as treatment and prognosis of the patients were investigated.Results:Of the 12 cases, 10 (83.3%) were men and 2 (16.7%) were women. The median (interquartile range) age was 51 (27-64) years. Eleven (91.7%) patients lived in rural regions, and seven (58.3%) had a history of tick contact. Five patients were hospitalized in an external center with a preliminary diagnosis of COVID-19 and transferred to our center due to clinical and laboratory deterioration. Loss of appetite, headache, fever, weakness, and muscle-joint pain were the most common complaints of the patients. Following the suspicion of COVID-19, thoracic computed tomography (CT) was performed in six patients, five of whom were transferred to an external center. None of the patients had any pathological findings following thoracic CT.Conclusion:Although it is thought that the COVID-19 pandemic will end in the following months owing to vaccine applications, it can be predicted that sporadic cases will still occur for a long time. Therefore, clinicians should take CCHF into consideration in their differential diagnosis. Also, it should be remembered that co-infections can be observed in endemic areas.

Introduction: Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis, which can affect any organ. The incidence of TB has increased due to the increase in the number of diseases and drugs that cause immunosuppression. The diagnosis of extrapulmonary TB (EPTB) is mostly clinical, histopathologic, radiologic, less frequent microbiological diagnosis. In our study, it was aimed to reveal the data helpful in the diagnosis by retrospectively examining the demographic and clinical data of the patients with EPTB. Materials and Methods: The patients who had a diagnosis of EPTB and were followed up between January 2012 and March 2017 in Fırat University Hospital, Department of Infectious Diseases and Clinical Microbiology were included in the study. Data were analyzed using Statistical Packages for the Social Science 22 statistical program. Results: The study included 125 patients, 28.8% were male and 71.2% were female. The mean age was 46.3±17 years. Of the patients with EPTB diagnosed; 49% had lymphadenitis, 14% musculoskeletal system involvement, 3% miliary involvement, 10% genitourinary system involvement, 4% central nervous system involvement, 5% gastrointestinal system involvement, 5% mastitis, and 9% had other organ involvements. Patients most frequently presented with complaints of swelling, sweating and fever. Tuberculin skin test (TST) was positive in 61.1% of the patients and quantiferon test was positive in 71% of the patients. Growth in mycobacterial culture was found in 12.8% of our patients, polymerase chain reaction positivity in 6.4%, and acid-resistant staining positivity in 16.8%. Granuloma structures were seen in 81.9% of the patients who underwent histopathological examination, and caseification necrosis was detected in 64.7% of the granuloma structures. Conclusion: Tuberculosis must be considered in the differential diagnosis of infectious diseases in which no etiology is detected in areas where TB is common, such as our country. It is thought that none of the EPTB diagnostic methods have the sensitivity and specificity that can be used alone, and that the evaluation of TST or quantiferon can still be used for diagnosis. There is a need for new tests that have high sensitivity and specificity for the diagnosis of EPTB.

Objective:The present study aimed to evaluate Crimean-Congo Haemorrhagic Fever (CCHF) in patients hospitalized in our hospital.Methods:A total of 61 adult patients who were diagnosed as having CCHF between January 2011 and August 2018, in whom the diagnosis was confirmed by detecting virus-specific IgM by ELISA and/or by showing viral RNA by RT-PCR and who were managed at our clinic were evaluated retrospectively for their epidemiological and clinical findings, treatment and prognosis.Results:Of the 61 cases, 41 (67.2%) were male and 20 (32.8%) female. The mean age of the patients was 45.31±2.12 years. Sixty (98.4%) patients were living in rural area. Forty four patients (72.1 %) had a tick-bite history. According to months, most of the cases were seen in June, July and May, respectively. Fever, weakness and loss of appetite were the most common complaints of the patients. Treatment of ribavirin was started on the day of admission in all patients. One patient who was admitted in the late period died. The other 60 patients were discharged after being healed.Conclusions:Especially during summers when the disease is seen frequently, the history of tick contact should be questioned and tick should be searched in the examination in the patients with suspected clinical findings. A significant number of the patients do not have a known tick contact. Therefore, training meetings should be organized about the symptoms and findings of the disease in the endemic areas and awareness should be raised among the community and the doctors working in emergency services and primary care.

Introduction: Nosocomial infections continue to be an important health problem since they seriously increase the rate of mortality and morbidity as well as hospitalization period and treatment costs. Acinetobacter spp. have an important place among the factors that cause hospital infections. Fast and accurate detection of Acinetobacter baumannii outbreaks is important in the treatment and control of epidemic infections. In our study, it was aimed to investigate the molecular similarities of carbapenem resistant A. baumannii isolates isolated as hospital infectious agents with Pulsed-Field Gel Electrophoresis (PFGE) method. Materials and Methods: This study was conducted in a medical center to examine the genetic relationship of a specific agent group detected in the non-pandemic period and is a cross-sectional study. In our study, the molecular similarities of 93 carbapenem resistant A. baumannii isolates isolated as hospital infectious agents from various clinical materials sent to Fırat University Hospital Central Laboratory and Infectious Diseases Department Laboratory between December 1, 2013 and June 30, 2014 were investigated with PFGE method. Results: A. baumannii strains showed 30 different PFGE profiles. Clonally related strains were included in seven different clusters. Eighty of 93 A. baumannii strains in total were included in any cluster. The clustering rate of the strains was found to be 86%. When the isolate dates of 55 strains in 1 cluster with the highest number of isolates were examined in our study, it was seen that this clone survived in our hospital for about five months. Conclusion: This study showed that A. baumannii strains isolated as nosocomial infection agents can survive for a long time. It was thought that carbapenem resistance spread horizontally among Acinetobacter spp. It was concluded that the necessity of training activities for infection control measures and compliance should be examined, and antibiotic use policies should be revised in terms of carbapenem resistance.

Introduction: This study aimed to determine the epidemiological data, clinical and laboratory findings, morbidity, and mortality of patients with central nervous system infection (CNSI). Materials and Methods: Patients who were followed-up in our clinic with a diagnosis of CNSI between 2013 and 2018 were reviewed retrospectively. Results: A total of 55 patients with a mean age of 46±19 (19-90) years were included in the study; 58.1% of the patients were male. Acute bacterial meningitis was observed in 54.5% of the patients, aseptic meningitis in 23.6%, tuberculous meningitis in 5.5%, and meningoencephalitis in 16.4% (88.8% of these patients were defined as highly probable encephalitis). The most common symptom was fever. The prevalence of the classical triad (fever, neck stiffness, and change in mental status) in patients with acute bacterial meningitis was 36.6%. Streptococcus pneumoniae was the most common causative agent identified in cerebrospinal fluid (CSF) and blood culture. Cerebrospinal fluid acid-fast bacillus positivity in tuberculous meningitis and CSF herpes simplex virus polymerase chain reaction-1 positivity in meningoencephalitis was 33.3%. The complication rate was 18.1%. The only mortality was in one patient with acute bacterial meningitis. Conclusion: According to the results of our study, fever, change in mental status, headache, and signs of meningeal irritation are essential in predicting CNSI. However, these indicators rarely presented altogether in our patients. Therefore, patients who do not exhibit the classical triad but are suspected of CNSI should undergo lumbar puncture for CSF analysis and antimicrobial treatment should be started as soon as possible. The low mortality rate among our patients once again demonstrates the importance of this approach.

Guidelines include recommendations of experts from various specialties within a topic in consideration of data specific to each country. However, to date there has not been a guideline standardizing the nomenclature and offering recommendations for intra-abdominal infections (IAIs) in Turkey. This is mainly due to the paucity of laboratory studies regarding the clinical diagnosis and treatment of IAIs or the sensitivity of microorganisms isolated from patients with IAIs. However, due to the diversification of host characteristics and advancements in technological treatment methods, it has become imperative to “speak a common language”. For this purpose, meetings were formed under the leadership of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey (EKMUD) consisting of 15 experts in IAIs from the Turkish Surgical Association, Turkish Society of Colon, Turkish Hernia Society, Turkish Society of Hepato-Pancreato-Biliary Surgery, and the Turkish Society of Hospital Infections and Control; and relevant studies were analyzed.. Ultimately, the suggestions for adults found in this consensus report were prepared using available data from Turkey, and referring predominantly to the 2010 guidelines for diagnosing and managing complicated IAIs in adults and children by the Infectious Diseases Society of America and the Surgical Infection Society. Recommendations are conducted in two sections from the initial evaluation of patients for diagnosis to treatment approach for IAI. This Consensus Report was presented in Turkey EKMUD 2016 Congress/Antalya and subsequently opened for any suggestions in Turkey EKMUD and Turkish Surgical Association official web sites for a month. The manuscript was updated according to the suggestions.

Introduction: The aim of this study was to determine the causative agents of community-acquired lower urinary tract infections (CALUTIs) in primary care. We also aimed to evaluate the antimicrobial susceptibility rates of urinary Escherichia coli isolates to various oral antibiotics and to assist primary care physicians with antibiotic selection. Materials and Methods: The study was performed in 55 primary care centers in 13 cities between May and July 2009. Adult patients with at least two of dysuria, pollakiuria, nocturia, suprapubic tenderness, or blurred urine symptoms, but not fever, were included in the study. Urinary samples were obtained and patient data were recorded at the primary care centers. Results: Totally, 400 patients were enrolled. In 175 (43.8%) patients, urine cultures yielded a urinary pathogen. The most frequently encountered pathogen was E. coli (62.8%). Among E. coli isolates, the lowest resistance rates were detected for nitrofurantoin (0.9%) and fosfomycin (3.6%) and the highest for trimethoprim/sulfamethoxazole (43.6%) and amoxicillin/clavulanate (41%). Resistance rates to quinolones were 23.6% for ciprofloxacin and 21% for levofloxacin. Minimum inhibitory concentration (MIC)50 and MIC90 values for ciprofloxacin and levofloxacin were 0.015 and 32 μg/mL and 0.06 and 16 μg/mL, respectively. Quinolone resistance was significantly higher in patients who received an antimicrobial treatment within the last three months (p< 0.001). Extended spectrum beta-lactamase (ESBL) positivity was detected in 15 of 110 (13.6%) E. coli isolates. Quinolone resistance was significantly higher among ESBL positive than ESBL negative strains (53.3% vs. 15.8%, p= 0.002). Conclusion: In conclusion, the most frequent causative agent in CALUTIs was E. coli. The lowest resistance rates among E. coli isolates were detected for nitrofurantoin and fosfomycin. Resistance rates to quinolones were over 20% in our study. Our identifikasyostudy provides important data about the causative agents and their antibiotic susceptibilities and also contains valuable data for rational antibiotic usage in the treatment of CALUTI in Turkey.